A risk-based framework to support conversion decision-making during minimally invasive left pancreatectomy: results from a multicentre registry
Rattachement africain : it, ca, ru. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Minimally invasive left pancreatectomy (MILP) is increasingly adopted worldwide, but conversion to open surgery still occurs and is associated with poorer postoperative outcomes. Tools to identify patients at increased risk of conversion are limited. This multicentre registry-based study included patients undergoing laparoscopic (LLP) or robot-assisted (RLP) MILP within the IGOMIPS registry. Predictors of conversion were analysed using multivariable logistic regression. A simple preoperative risk score, the modified Conversion Risk Score (mCRS), was derived from independent predictors of conversion. We explored the interaction between preoperative risk, intraoperative complexity, and center-level variability. Of the 2127 MILPs included, 1235 (58.1%) were performed laparoscopically, and 892 (42.9%) were robot-assisted. Conversion occurred in 180 cases (8.5%) and was more frequent during LLP than RLP (11.8% vs 3.8%). Age ≥ 61 years, tumour diameter ≥ 35 mm, and preoperative suspicion of pancreatic malignancy were independently associated with conversion and formed the mCRS (range 0-5). Conversion rates increased progressively with higher mCRS values (ranging from 3.5% to 20.6%). When a high preoperative risk was combined with intraoperative complexity, the probability of conversion increased further (up to 19%). Differences in conversion rates between centres were primarily explained by case volume. In this large multicentre cohort, conversion during MILP was associated with patient age, tumour size, and suspected malignancy. The proposed mCRS, combined with intraoperative cues, may support risk stratification and timely intraoperative decision-making.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A risk-based framework to support conversion decision-making during minimally invasive left pancreatectomy: results from a multicentre registry
- Date Crossref
- 31/03/2026
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Verona Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Vita-Salute San Raffaele University pays non établi dans la noticeUniversité ou école supérieure
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Ospedale Cisanello pays non établi dans la noticeÉtablissement de santé
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Humanitas University Department of Biomedical Sciences pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Humanitas Research Hospital pays non établi dans la noticeÉtablissement de santé
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Università Cattolica del Sacro Cuore pays non établi dans la noticeUniversité ou école supérieure
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Agostino Gemelli University Polyclinic pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Casa di Cura Villa Garda pays non établi dans la noticeÉtablissement de santé
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Pancreas Centre (Canada) pays non établi dans la noticeEntreprise
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Ospedale Sant'Anna pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Ospedale Civile di Legnano pays non établi dans la noticeÉtablissement de santé
Department of Surgery — University of Verona, Vita-Salute San Raffaele University et Ospedale Cisanello, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.